Here are some goals and strategies for how to live a healthy and happy life. Some of this comes from personal experience and opinion, but a decent amount is evidence-based. For me, these are aspirational; I don’t live up to them to the degree I’d like. And to the extent I do, it’s partly because I’ve had the good fortune to stumble into them rather than because I consciously set out to achieve them.
Income is one of the best predictors of happiness, and education is one of the clearest routes to higher income.1 In the United States, the boost in happiness is smaller beyond a household income of about $75,000,2 so you don’t need to get a medical degree or even necessarily a four-year college degree. But schooling has lots of other benefits too, from meeting potential friends to learning self-discipline to getting a better understanding of how things work.
For those considering college, the cost is often an impediment. But the “sticker price” of college tends to be misleading; for students with limited financial resources, there is lots of financial aid along with income-based loan repayment options.3 The problem is that few people know about these.
What if you can’t get into a good and/or affordable four-year college? Consider community college. They’re widely available, they admit most students who have a high school degree, and they’re relatively inexpensive. They also allow flexibility in course scheduling. A two-year certificate or degree is helpful, and it offers opportunity to transfer to a four-year college if that’s what you want.4
HAVE A PURPOSE
Do things you feel competent at and enjoy.
How do you figure out what that is? It’s difficult to decide what you like and what you’re good at simply by thinking. Better to experiment. Try new things. If they don’t work or you don’t like them, try something else. And see failure as helpful, not shameful; it gives you useful information.5
Spend a lot of time with friends and family. Resist the temptation to settle for small amounts of “quality time.” To the extent you’re able, commit to more hours, more days, more weeks. It doesn’t have to be only family and friends — pets, neighbors, workmates, teammates, support group members, acquaintances, or others may do just as well.
Eat mostly vegetables, fruits, beans, lentils, whole grains, nuts, and seeds, in unprocessed or minimally-processed form, and in moderate quantities.8 Drink mostly water.
There is a great deal of food science research on the health impact of individual substances (omega-3s, cholesterol, etc) and individual foods, but this has yielded limited information about what we should and shouldn’t eat, perhaps because scientists haven’t yet identified the really important substances, or more likely because there are complex interactions within and between foods that outweigh the impact of specific substances.9
Our knowledge about how best to eat comes mainly from comparative analysis of eating patterns (diets) — of people in different places, of people in the same place over time, and of people who move between places. For instance, Dan Buettner and his research team studied places where a larger-than-normal share of the population lives to age 100 or more.10 It isn’t only about living longer; the centenarians in these places — in Costa Rica, Greece, Italy, Japan, and the United States — have “healthy lives with vitality until the very end.” Buettner identifies several commonalities: (1) Eat mostly plants, no ultraprocessed foods, not too much. (2) Move frequently. (3) Have a purpose. (4) Belong. (5) Relieve stress. (I say more about 2-5 above and below.)11
A very helpful summary of what we know and don’t know, with both a good overview and lots of detail, is How to Eat: All Your Food and Diet Questions Answered, by Mark Bittman and David Katz. A few passages12:
- “What do you mean by the terms ‘whole food’ and ‘real food’? It’s pretty simple: food that’s as close to ‘natural’ — that is, as nature produces it — as possible. We know that ultraprocessed (or hyperprocessed) foods are bad for us: That’s the majority of food invented in the twentieth century — junk food. Whole food is generally food that hasn’t been tinkered with much, that doesn’t need a label, and is its own ingredient.”
- “What we don’t have is a single randomized trial, beginning before birth, lasting a lifetime, enrolling tens of thousands — to show once and for all ‘what diet is best.’ What we do have is a mountain of evidence, built a bit at a time, supporting the theme of … real foods, close to natural form, mostly plants, augmented a little bit by almost whatever else you like. It’s that simple.”
- “We don’t need to create randomized controlled trials to prove in a less controversial way that fruits and vegetables are good for people…. We have no randomized controlled trials to prove the harms of smoking…. What we know about smoking is from the experience and pattern consistency of large populations, when there is a dramatic change when they smoke. It’s not from randomized trials…. Are there other, more reliable ways to learn about nutrition? Absolutely. The truly reliable way is to look at the big picture — to see the elephant — not just a piece; to look across the broadest expanse of evidence, including but not limited to intervention trials, what we know about our own native past, and what we can observe about the fate of whole populations over generations. Different kinds of evidence are like different pieces of the same, great puzzle — you need lots of different pieces to complete the picture.”
- “Should I be eating high or low in fat? What about high or low in carbs? It doesn’t matter. You don’t need to worry about it. One of the greatest distractions in modern thinking about diets is how high or low a dietary pattern is in particular macronutrients.”
- “You don’t need any particular food to have a great diet. If you have a great diet, you will derive maximum health, vitality, and longevity benefits from it, and no so-called superfood will add to that…. Overwhelmingly, the evidence links large-scale dietary pattern, not the addition of ‘superfoods,’ to health. One of the reasons we struggle so in our apparent confusion about diet is that there’s a lot of research attempting to isolate the effects of any one food. That’s nearly impossible to do.”
- “Eat a variety of wholesome foods, and the nutrients will take care of themselves…. What do these magical nutrient compounds do? We don’t know exactly. That’s the beauty of it. They make you healthy…. The notion that you can define the quality of a diet on the basis of a particular nutrient level is misguided and antiquated, and it needs to be abandoned. It’s really about the food as a whole, not food’s component parts.”
While there is very strong evidence linking a whole-food plant-based diet — heavy on vegetables, fruits, beans, lentils, whole grains, nuts, and seeds, light on animal products and ultraprocessed foods — with better health, as far as I’m aware we don’t currently know the magnitude of the effect. For instance, if a person switches at age 20 from a traditional western diet to a whole-food plant-based diet, how much will her life expectancy increase? I haven’t come across a good answer.13
On health grounds alone, the available evidence doesn’t favor a plant-only diet over a plant-predominant diet.14 The case for eating only plants is strengthened by ethical considerations, climate concerns, and growing antibiotic resistance due to large-scale animal production.15
A generation or even a decade ago, eating a diet of mostly or only minimally-processed plants in the United States likely meant a lot of blah meals. Happily, that’s no longer true. There are hundreds of tasty, healthy plant-only dishes you can make or buy.16
Here are a few short reads, podcasts, and videos on how to eat well:
- David L. Katz, Plant Proof podcast with Simon Hill, Episode 108, 2020.
- Jane E. Brody, “Secrets to Lasting Weight Loss,” New York Times, 2018.
- Gil Carvalho, Nutrition Made Simple YouTube channel.
- Movies inevitably gloss over important details, but these are pretty good: Forks Over Knives, 2011; Game Changers, 2019; Code Blue, 2020.
It doesn’t have to be strenuous. Low-intensity activity is good enough. Walk, cycle, garden, cook, clean the house or yard, water the plants, take the stairs, hike, do tai chi or yoga, swim.17
We tend to underestimate the happiness benefit of leisure time. According to one recent calculation, taking 8 additional vacation days in a year yields, on average, a boost in happiness equivalent to that from $4,500 of additional income. Outsourcing your most disliked household chore boosts happiness the same amount as an additional $18,000 in income. The happiness increase from spending less time at work and more with friends and family is even greater.20
There also is evidence that frequent interruptions of our leisure time make us feel as though we are time deprived. Smart phones and social media are a key culprit here.21 I use my phone for calls, texts, email, and an RSS feed (no Twitter, Instagram, TikTok, Reddit, Facebook, or other social media). The phone notifies me only when I get a call or text, which isn’t that often. I feel like this works pretty well, though that might not be true for others.
Stress is unpleasant, and it’s bad for both physical and mental health.22 Slow down, pause to appreciate (“smell the roses”), listen to music, laugh, smile, take a few moments or a few minutes to breathe slowly and deeply, meditate,23 do some gentle stretching, eat slowly and without phones or other electronic distractions, get enough sleep, pray, give thanks,24 forgive.
Inadequate sleep reduces energy, increases irritability, and impedes cognitive functioning. It appears to be causally linked with overweight and obesity, heart disease, stroke, type 2 diabetes, anxiety, depression, cancer, and dementia.25
How much does it matter? According to one recent study of 55,000 people aged 50 to 75 in England, Finland, and Sweden, suboptimal sleep reduces healthy and chronic-disease-free life expectancy by one to six years.26 That suggests sleep is quite important. On the other hand, sleep patterns don’t seem to correlate with major over-time trends or cross-country differences in health outcomes.27
Adults tend to do best if they regularly get 6 to 9 hours of sleep. Many sleep experts have concluded that the lower bound is 7 hours.28 However, in Japan and South Korea people appear to get fewer than 7 hours per night on average, and in those two countries life expectancy is among the world’s highest and obesity is among the lowest.29 Several recent studies of several hundred thousand individuals have found that 7 hours per night is optimal, with a bit less than that just as good as a bit more.30 Evidence from existing “preindustrial” societies also challenges the conclusion that 7 hours is the minimal healthy amount.31
Sleep with few or no interruptions may be just as important, possibly more important, than sleep duration.32
Evidence-based strategies for better and longer sleep include going to bed and waking up at the same time every day, setting your sleep schedule based on your chronotype (about a third of people are early birds, a third are night owls, and a third are in between), keeping your sleep environment dark and below 70°F, minimizing caffeine and alcohol consumption in late afternoon and evening, avoiding sleep-impeding drugs (such as Adderall and Ritalin), avoiding naps after 3pm, avoiding heavy meals and vigorous exercise in late evening, minimizing screen use immediately before bed, and getting treatment for disorders such as sleep apnea and chronic insomnia.33
SEEK HELP FOR MENTAL ILL-HEALTH
In the affluent nations for which good data are available — the US, UK, Australia, and Germany — mental health problems are the single largest contributor to misery (very low life satisfaction). They are more influential than physical health problems, low income, low education, unemployment, marital status, gender, or age. For many people, treatment can help.34 Medication is effective for approximately 50% of people with anxiety and depression, and the success rate for cognitive behavioral therapy is even higher.35
LIVE A “GOOD ENOUGH” LIFE
Dream big, shoot for the stars, aim to excel, compare yourself to others. But don’t go overboard. If you spend too much time and effort striving for something better, you may go through life with limited enjoyment. And there’s so much to enjoy. Don’t miss it because you’re obsessed with getting better or getting ahead.
DON’T DEFINE WORTH BY ACCOMPLISHMENTS
Salary, job title, employer, college — these things too often determine how we assess a person. Much more important is the type of person you are. Are you kind, empathetic, helpful to those who depend on you, and also to those who don’t?
Does this contradict my earlier point about the value of education and income? Not at all. You’re likely to be healthier and happier if you have more education, but that doesn’t mean the way you view other people should hinge on their schooling, job, or income.
Jesus’s version: “Do unto others as you would have them do unto you.” The (14th) Dalai Lama’s: “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”
A person’s beliefs, values, and behaviors are determined by a complex mix of biology, experiences, contacts, and other things. This makes it very difficult to understand why a particular individual thinks what they think and acts the way they do. Similarly, despite huge advances in scientific knowledge over the past few centuries, there is an enormous amount we don’t understand. This calls for humility.
If you’ve been lucky — in your genes, parents, teachers, friends, job, partner, or other things — give something back. A good way to do this is by volunteering or donating, but for some people the best way might be by being better at your job, or being a better neighbor, or joining a social movement, or getting involved in politics.
If you have more money than you need: There now is good evidence that nongovernmental organizations can save lives in the world’s poorest countries, and we know approximately how much it costs to do so.36
Generosity isn’t just good. It also seems to make us happier.37
- Lane Kenworthy, “Happiness,” The Good Society; Kenworthy, “What Good Is Education?,” The Good Society. ↩
- Kenworthy, “Happiness.” ↩
- Lane Kenworthy, “College Education,” The Good Society. ↩
- Kenworthy, “College Education.” ↩
- Bill Burnett and Dave Evans, Designing Your Life, Knopf, 2016; Robert H. Frank, “The Incalculable Value of Finding a Job You Love,” New York Times, 2016. ↩
- This conclusion is from a Danish analysis of nearly 3,000 sets of identical and nonidentical twins over approximately 100 years. A.M. Herskind et al, “The Heritability of Human Longevity: A Population-Based Study of 2872 Danish Twin Pairs Born 1870-1900,” Human Genetics, 1996. Consistent with this, the American Heart Association estimates that 80% of cardiovascular disease is preventable; see Simon Hill, The Proof Is in the Plants, Penguin, 2021, p. 82. ↩
- GBD 2016 Risk Factor Collaborators, “Global, Regional, and National Comparative Risk Assessment of 84 Behavioural, Environmental and Occupational, and Metabolic Risks or Clusters of Risks, 1990–2016: A Systematic Analysis for the Global Burden of Disease Study 2016,” The Lancet, 2017. ↩
- As Michael Pollan puts it: “Eat food. Mostly plants. Not too much.” Pollan, In Defense of Food, Penguin, 2008. ↩
- Pollan, In Defense of Food; D.L. Katz, M.C. Karlsen, M. Chung, M.M. Shams-White, L.W. Green, J. Fielding, A. Saito, and W. Willett, “Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM): Introduction of a Strength-of-Evidence Approach Based on a Methodological Systematic Review,” BMC Medical Research Methodology, 2019. ↩
- Dan Buettner, The Blue Zones, National Geographic, 2008; Dan Buettner, The Blue Zones Solution, National Geographic, 2015. ↩
- Dean and Anne Ornish note that there are (at least) nine pathways through which these eating and other lifestyle strategies may contribute to good health: “chronic inflammation and immune system dysfunction; chronic emotional stress, depression, overstimulation of the sympathetic nervous system, stress hormones, and lack of sleep; gene expression and sirtuins; telomeres; the microbiome; oxidative stress, cellular metabolism, and apoptosis; angiogenesis; stasis.” Scientists don’t currently know which of these, if any, matter more than others. Dean Ornish and Anne Ornish, Undo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases, Ballantine Books, 2019. ↩
- Mark Bittman and David L. Katz, How to Eat: All Your Food and Diet Questions Answered, Houghton Mifflin Harcourt, 2020. “What do you mean by…”: pp. 82-83. “What we don’t have…”: p. 14. “We don’t need to…”: pp. 202, 208, 215. “Should I be eating…”: p. 15. “You don’t need any particular…”: pp. 138-39. “Eat a variety of wholesome…”: pp. 75, 85, 201. See also Hill, The Proof Is in the Plants. ↩
- One suggestive finding is that “Compared to the general US population, vegetarian Adventists (vegetarians, vegans and pescetarians) from Loma Linda, California, who also regularly exercise and do not smoke, enjoy around ten to fourteen extra years of life.” Hill, The Proof Is in the Plants, p. 153. ↩
- Hill, The Proof Is in the Plants. ↩
- Mark Rowlands, Animal Rights: All That Matters, John Murray Press, 2013; Lane Kenworthy, “Climate Stability,” The Good Society; Michael J. Martin, Sapna E. Thottahil, and Thomas B. Newman, “Antibiotics Overuse in Animal Agriculture: A Call to Action for Health Care Providers,” American Journal of Public Health, 2015. ↩
- Oldways | Nora Cooks | New York Times | High-carb Hannah | Kenworthy. ↩
- Buettner, The Blue Zones; Buettner, The Blue Zones Solution; Jeanna Vazquez, “Studies Find Even Minimal Physical Activity Measurably Boosts Health,” UC San Diego News Center, 2020. ↩
- Buettner, The Blue Zones; Neal Lathia, Gillian M. Sandstrom, Cecilia Mascolo, and Peter J. Rentfrow, “Happier People Live More Active Lives: Using Smartphones to Link Happiness and Physical Activity,” PLoS One, 2017; Gretchen Reynolds, “Get Up and Move. It May Make You Happier,” New York Times, 2017. ↩
- Annie Murphy Paul, “This Conversation Will Change How You Think About Thinking,” The Ezra Klein Show, 2021. ↩
- Ashley Willans, Elizabeth W. Dunn, Paul Smeets, Rene Bekkers, and Michael I. Norton, “Buying Time Promotes Happiness,” Proceedings of the National Academy of Sciences, 2017; Ashley Whillans and Hanne Collins, “Accounting for Time,” Harvard Business Review: The Big Idea, hbr.org, 2019; Laura M. Giurge and Ashley Whillans, “Beyond Material Poverty: Why Time Poverty Matters for Individuals, Organisations, and Nations,” Working Paper 20-051, Harvard Business School, 2020, table 1. ↩
- Ashley Whillans, Time Smart, Harvard Business Review Press, 2020, ch. 1. ↩
- Stress triggers a “fight-or-flight” response by the body. The amygdala sends a distress signal to the hypothalamus, which tells the sympathetic nervous system to pump adrenaline into the bloodstream and to release cortisol. This response evolved as a helpful survival tool in the face of acute threats, but chronic low-level stress keeps it activated. That can result in the unpleasant sensation of constant tension. It also can have adverse long-term health effects: it can damage blood vessels and arteries and contribute to the buildup of fat tissue, increasing the risk of a heart attack or stroke; it can increase inflammation; it can reduce the digestive system’s effectiveness. See Harvard Health, “Understanding the Stress Response.” ↩
- Meditation may be a particularly valuable tool for reducing stress. It can help in two ways. One is controlled breathing. Slow, deliberate breathing tells the parasympathetic nervous system that all is well, which reduces the release of stress hormones that are damaging to physical health. (See Lesley Alderman, “Breathe. Exhale. Repeat. The Benefits of Controlled Breathing,” New York Times, 2016.) The other is mindfulness, which, roughly speaking, is the ability to consciously recognize the thoughts and emotions — urges, desires, cravings, frustrations, fears, insecurities, bad memories, imagined scenarios — running through your brain at any given moment. Some of these thoughts and emotions are negative. Mindfulness doesn’t get rid of them, but it allows us to recognize that they are in fact thoughts and emotions rather than reality, which enables us to respond more productively. (See Yanti Lin et al, “Deconstructing the Emotion Regulatory Properties of Mindfulness,” Frontiers in Human Neuroscience, 2016; Dan Harris, Jeffrey Warren, and Carlye Adler, Meditation for Fidgety Skeptics, Harmony Books, 2017; Hedy Kober et al, “Let It Be: Mindful Acceptance Down-Regulates Pain and Negative Emotion,” Social Cognitive and Affective Neuroscience, 2019.) However, there is a lot we don’t currently know about meditation’s impact. How large is it? How frequently and how long does a person need to meditate in order to get the benefit? ↩
- I find gratitude to be helpful. Advocates suggest it can have sizable and lasting positive effects on mental and physical well-being. (See, for instance, Robert A. Emmons, The Little Book of Gratitude, Gaia, 2016.) But recent meta-analyses suggest that such effects are mostly small and/or short-lived. (See Leah R. Dickens, “Using Gratitude to Promote Positive Change: A Series of Meta-Analyses Investigating the Effectiveness of Gratitude Interventions,” Basic and Applied Social Psychology, 2017; Lilian Jans-Beken, Nele Jacobs, Mayke Janssens, Sanne Peeters, Jennifer Reijnders, Lilian Lechner, and Johan Lataster, “Gratitude and Health: An Updated Review,” Journal of Positive Psychology, 2019; David R. Cregg and Jennifer S. Cheavens, “Gratitude Interventions: Effective Self-Help? A Meta-Analysis of the Impact on Symptoms of Depression and Anxiety,” Journal of Happiness Studies, 2020.) ↩
- Matthew Walker, Why We Sleep, Scribner, 2017; Lauren Hale, Wendy Troxel, and Daniel J. Buysse, “Sleep Health: An Opportunity for Public Health to Address Health Equity,” Annual Review of Public Health, 2020. ↩
- Sari Stenholm et al, “Sleep Duration and Sleep Disturbances as Predictors of Healthy and Chronic Disease-Free Life Expectancy Between Ages 50 and 75: A Pooled Analysis of Three Cohorts,” Journals of Gerontology: Medical Sciences, 2019. ↩
- For instance, sleep time has been decreasing steadily in the United States since the 1940s (Walker, Why We Sleep, pp. 177, 296). But life expectancy has increased for most of that period, cancer incidence has varied, and obesity has increased but only since around 1980. On cross-country differences, see below. ↩
- Max Hirshkowitz et al, “National Sleep Foundation’s Sleep Time Duration Recommendations: Methodology and Results Summery,” Sleep Health, 2015; Walker, Why We Sleep; Stenholm et al, “Sleep Duration and Sleep Disturbances as Predictors of Healthy and Chronic Disease-Free Life Expectancy Between Ages 50 and 75”; Kannan Ramar et al, “Sleep Is Essential to Health: An American Academy of Sleep Medicine Position Statement,” Journal of Clinical Sleep Medicine, 2021; Donald M. Lloyd-Jones et al, “Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health. A Presidential Advisory From the American Heart Association,” Circulation, 2022. ↩
- Country sleep data: James Tozer, “Which Countries Get the Most Sleep?,” The Economist: 1843, April-May 2018, using data from one million worldwide users of Sleep Cycle, an app that tracks night-time sound and movement. See also Marco Hafner et al, “Why Sleep Matters — The Economic Costs of Insufficient Sleep: A Cross-Country Comparative Analysis,” RAND Health Quarterly, 2017, table 1, using data from the National Sleep Foundation. Life expectancy: Lane Kenworthy, “Longevity,” The Good Society. Obesity: Lane Kenworthy, “Weight Moderation,” The Good Society. ↩
- Thomas Svensson et al, “Association of Sleep Duration with All- and Major-Cause Mortality Among Adults in Japan, China, Singapore, and Korea,” JAMA Open Network, 2021; Yuzhu Li et al, “The Brain Structure and Genetic Mechanisms Underlying the Nonlinear Association between Sleep Duration, Cognition, and Mental Health,” Nature Aging, 2022. ↩
- Anahad O’Connor, “Do We Really Need to Sleep 7 Hours a Night?,” New York Times, 2015. ↩
- Walker, Why We Sleep; Stenholm et al, “Sleep Duration and Sleep Disturbances as Predictors of Healthy and Chronic Disease-Free Life Expectancy Between Ages 50 and 75.” ↩
- “Are You Sleep-Deprived? Learn More About Healthy Sleep,” NIH Medline Plus, 2012; Walker, Why We Sleep; Jane Brody, “The Health Toll of Poor Sleep,” New York Times, 2021. ↩
- Richard Layard, Dan Chisholm, Vikram Patel, and Shekhar Saxena, “Mental Illness and Unhappiness,” in World Happiness Report 2013, UN Sustainable Development Solutions Network, 2013; Richard Layard and David M. Clark, Thrive: How Better Mental Health Care Transforms Lives and Saves Money, Princeton University Press, 2015, ch. 5; Andrew E. Clark, Sarah Flèche, Richard Layard, Nattavudh Powdthavee, and George Ward, “The Key Determinants of Happiness and Misery,” World Happiness Report 2017, UN Sustainable Development Solutions Network, 2017. ↩
- Layard and Clark, Thrive. ↩
- Peter Singer, The Life You Can Save, 2nd edition, 2019, available free online. ↩
- Tara Parker-Pope, “How To Be Happy,” New York Times; Nicole Karlis, “Why Doing Good Is Good for the Do-Gooder,” New York Times, 2017. ↩